Why is it that compared to other mental illness's like depression, ADHD, autism and anxiety people seem to be so hostile to NPD? I always see things about 'mental health awareness' yet this is never applied to personality disorders.
Just look up "narcissism", "NPD" or "narcissistic personality disorder" and the results are about how dangerous people with NPD are and how to spot somebody with NPD or if your ex boyfriend is a narcissist etc... etc...
I was watching this video earlier by a YouTube user 'ShortFatOtaku' called "Low IQ Twitter Discourse Awards!" and there was this one guy on twitter who said that if you claim advocate for the mentally ill you such do so with personality disorders as well. A statement I completely agree with:
https://youtu.be/3EJedJ8MhNA YouTube
ShortFatOtaku response with "wow your going to let that narcissist kill you and take everything from you?" I shouldn't have to explain how bad faith and unhinged that is.
Why do people think this way about narcissists? Having NPD doesn't make someone an inherently bad person. As someone who has NPD I haven't abused or manipulated anyone ever. Sure, I struggle with empathy, I have to make an effort to think about other people and ok I have a never ending need for validation but that doesn't mean I'm a bad person I understand I have a problem I didn't choose to be like this. Manipulation and grandiosity are awful traits that I have but they don't define me. I'm a good friend, I'm a good sister, I'm a good coworker and there are people out there who benefit from my existence. NPD doesn't have to define me I'm more then my diagnosis.
I think the important thing is really just that mental illness doesn't shield you from accountability for how you impact other people, and for a personality disorder that primarily manifests in traits that harm people, that's a hard thing to reconcile with that person's merits. Doesn't mean you can't or shouldn't, just that because you are still responsible for potentially hurting people, and have a disorder that makes you very likely to do so, those things will be very hard for people to square.
Another example is paraphilias. Paraphilias can include things like pedophilia, which manifests in a desire to do something that would subject someone to profound amounts of trauma, the likes of which most of us couldn't even begin to appreciate. Can someone with such a paraphilia be a good person who is kind, and does not harm people in that way? Yes. Can that person be largely a good person in most contexts, but cause people enormous harm as a result of their paraphilia? Also yes.
In some ways we are all people with conditions that affect who we would be otherwise, and in other ways we are all just people, and conditions are used descriptively to communicate the traits that we have.
At the end of the day, the thing that matters is how you treat people. If you cause people harm, it might be more understandable given the context of a personality disorder, but it doesn't absolve you of any responsibility. And if you don't, then you haven't done anything wrong. And I mean that for each moment in time, each interaction. Humans are messy and complicated, and generally ideas like "good person", "bad person", are reductive.
I'm sorry you feel trapped or defined by your diagnosis. That can be a painful place to be. I have a close friend with borderline personality disorder who has at times felt similarly. Only thing that matters is whether you're an asshole. Only thing that ever has mattered, only thing that ever will.
Edit: just want to be very clear- the fact that it will be hard for people to engage with you purely based on your behaviour in a given interaction is not something you deserve. Its the actions and how they affect people that count, even if I can empathize with why it'd be hard for people
Perfectly put, thank you
Thank you very much. As someone with a lot of challenges with mental illness myself, it's something I think about a lot.
"I think the important thing is really just that mental illness doesn’t shield you from accountability for how you impact other people,"
I never said it did but but everything else you said it's very reasonable. Easily the best response on this whole thread.
What's your primary occupation?
I don't presently have one, and when I do it'll probably be like waiter at waffle-house or something 😅
Why do you ask?
Drag thinks you've misunderstood the diagnostic criteria. The criteria specifically refer to manifestations of the traits that harm the patient. Traits that harm others aren't counted as diagnostically significant. Like, take the "excessive need for admiration" criterion. That one's only medically significant if the patient is suffering because of their need. If they're abusing other people into praising them and getting what they want, then they don't have NPD.
For example, Donald Trump has the traits as a layperson would understand them, but not as a psychiatrist would understand them. Because they're not hurting him. Doctors only care if the patient is suffering. No pain, no disorder.
Are you positive that's entirely correct? There are definitely disorders who's definitions are shaped by their impact on others, like Munchausen's by proxy, but I'm not a psychologist or psychiatrist. I could see it being described as a form of impairment to an important area of life to not being able to form healthy non-destructive relationships, and I think impairment is one of the criteria by which a disorder can be defined
I could also just be wrong though, and it's a fair point regardless. Perhaps "defined by" wasn't quite the right way to word things
Edit: upon rereading I didn't actually say it was "defined by", but the wording is still imperfect. I can only be but so anal about technicalities though; communicating my point is more important
Drag isn't especially familiar with MBP, but this is what Wikipedia says in the introduction. That the caregiver is convinced that they're suffering and that they need attention and sympathy. Those are the actions of someone who's in pain, and a link to trauma makes it all make sense.
But yes, the fact that medicine is for helping patients is controversial in the psychiatric community. There's considerable debate on the subject. But the guy who wrote the DSM IV criteria for NPD has stated in multiple interviews that Trump doesn't have NPD, because he isn't suffering.
American psychiatrists have to follow the Goldwater Rule, which says not to speculate on the disorders of public figures. Why? Because that's not what diagnosis is for. Diagnosis is the first step in a plan to treat a patient and help them. Diagnosis should never be about insulting, labelling, or stigmatising a patient in the eyes of others. That's a violation of the Hippocratic Oath.
You are not thinking of the hippocratic oath (there is no mention whatsoever of gossip about patients). The do no harm clause specifies bodily harm/abuse in a physical context. You have supplied a TV or Movie memory concerning diagnosis, or maybe you think HIPAA is somehow related to the oath. Many modern doctors don't take the traditional hippocratic oath. If you'd ever read the text, you would know why.
You've clearly rattled all this off without taking a single second to look at context. The goldwater rule isn't an actual law, and it does not in fact have an explicit analogue in the current APA ethics guidelines (though you can argue the same instruction is conveyed throughout a couple of the standards). You have made up rules that doctors live by in your brain. American psychologists do not "have to follow the goldwater rule". Every time I see you post it's some "I googled it!" regurgitation with absolutely no understanding of the topic, or insane ramblings about how we should be nice to AI. Your five minutes of searching is not going to help you think critically about anything. This is facebook user behavior.
That's not true. NPD diagnostic criteria in the DSM-5-TR (latest version) still contains manipulation efforts and similar behavior. Quote:
So... Donald Trump probably meets criteria for a narcissistic personality disorder diagnosis (if he ever agrees to start a "mental health journey").
And it's true that many disorders need to cause "clinically significant distress", but personality disorders can be diagnosed even if they don't cause distress to the person but causes it to others (e.g. ASPD). The DSM had to consider egosyntonic disorders, after all.
Number 6 is the only one that’s defined by the treatment of others
All 9 of those criteria only apply if they distress or impair the patient. Also, they're outdated. That's the DSM-IV's criteria. And they've been criticised -
https://www.mind-diagnostics.org/blog/narcissistic-personality/narcissistic-personality-disorder-dsm-5-criteria-and-treatment-options
That's why the DSM 5 criteria have more focus on the individual's impairment and distress: